Top 10 Public Health Achievements in the United States 1900-1999
Public health is credited with adding 25 years to the life expectancy of people in the United States during the last 100 years. Still, the average person doesn’t really know what public health is and what it does. The Centers for Disease Control and Prevention (CDC) has developed a list, the Ten Great Public Health Achievements in the 20th Century, to remind us of how far we've come, how we got here.
The list shows exactly what public health is -- the active protection of our nation's health and safety – and does – provides credible information to enhance health decisions and works in partnerships with local organizations to promote good health.
Most of the public health achievements happened in the 1900s. The Top Ten list reflects those actions that helped to prevent or had a major impact on illness, injury and death, in the United States. They are not ranked in order of importance. Please take a look at our quick view of these achievements. If you would like more information about any of the Top Ten Public Health Achievements, go to the CDC Web site at www.cdc.gov.
The Top Ten Public Health Achievements in the United States (1900-1999)
During the last century, Public Health Departments across the country have worked on putting laws and programs in place to support the following improvements in our health and safety.
Vaccination
At the beginning of the 20th century, infectious diseases were widespread in the United States. These diseases took a huge toll on the population. For example, in 1900 there were 21,064 reported cases of smallpox, and 894 patients died; in 1920 there were 469,924 reported cases of measles and 7575 patients died; and in 1922 there were 107,473 reported cases of whopping cough (pertussis) and 5099 patients died. During that time there were few effective treatments or measures that could be used to prevent these diseases. Since 1900, a number of vaccines have been developed against these and other diseases. Smallpox has been eradicated, and other diseases such as measles in children less than 5 years of age, have been reduced to record lows.*
Safer Workplaces
Work-related health problems, such as coal workers’ getting black lung disease (pneumoconiosis), were very common at the beginning of the century and are now under better control. Other workplace problems like severe injuries and deaths related to mining, manufacturing, construction, and transportation have also decreased since that time. Since 1980, safer workplaces have resulted in a 40% reduction in the number of deaths due to occupational injuries.*
Safer and Healthier Foods
Decreasing microbial contamination and increasing the nutritional content of food has resulted in safer and healthier foods. By identifying needed micronutrients and starting food-enrichment programs, the diseases caused by a major lack of nutrition, such as rickets, goiter, and pellagra, have almost been eliminated in the United States.*
Recognizing the Use of Tobacco as a Health Hazard
Recognizing the use of tobacco as a health hazard, and conducting related public health anti-smoking campaigns, has resulted in changes in our society. These changes have helped prevent people from starting to use tobacco and to stop others from smoking. They have also raised awareness about the need to stop exposing people to tobacco smoke, particularly in public places. Since the 1964 Surgeon General's report on the health risks of smoking, smoking among adults has decreased and millions of smoking-related deaths have been prevented.*
Motor Vehicle Safety
Improvements in motor vehicle safety come from efforts to make both vehicles and highways safer. Additionally, successful actions to change personal behavior such as using safety belts, installing child safety seats, using motorcycle helmets and decreasing drinking and driving, have helped to reduce the number of motor vehicle deaths in the United States.*
Healthier Mothers and Babies
Today, we have healthier mothers and babies because of programs that teach better hygiene and nutrition, antibiotics that are more available, greater access to health care, and major advances in maternal and neonatal medicine. Since 1900, infant mortality has decreased 90%, and maternal mortality has decreased 99%.*
Fluoridation of Drinking Water
Fluoridation of drinking water began in 1945. In 1999, fluoridation reached about 44 million people living in the United States. Safe and inexpensive fluoridation benefits both children and adults by preventing tooth decay. By using fluoridated water, tooth decay can be prevented in anyone regardless of socioeconomic status or access to dental care. Fluoridation has played an important role in the reductions in tooth decay (40%-70% in children) and of tooth loss in adults (40%-60%).*
Family Planning
Access to family planning and contraceptive services has changed the social and economic roles of women. Family planning has provided health benefits such as smaller family size and longer time between births of children. It has also increased opportunities for pre-conception counseling and screening, the use of barrier contraceptives to prevent pregnancy and transmission of human immunodeficiency virus and other STDs. All of these factors have contributed to fewer infant, child, and maternal deaths.*
Decline in Deaths from Coronary Health Disease and Stroke
Decline in deaths from coronary heart disease and stroke have come from modified risk behaviors in people, such as stopping smoking, and getting blood pressure under control. These efforts, along with improved early detection and better treatments, have reduced coronary heart disease and strokes during the past century. Since 1972, death rates for coronary heart disease have decreased by 51%.*
Control of Infectious Disease
Control of infectious diseases has resulted from clean water and improved sanitation. Infections such as typhoid and cholera are transmitted by contaminated water and were a major cause of illness and death in the early 20th century. These diseases have been reduced dramatically by improved sanitation. In addition, the discovery of antimicrobial therapy has been critical to successful public health efforts to control infections such as tuberculosis and sexually transmitted diseases (STDs).
* The list of achievements was developed to highlight the contributions of public health and to describe the impact of these contributions on the health and well being of persons in the United States. For more information or the supporting documents from local and state health departments and academic institutions whose activities on research, epidemiology, health education, and program implementation were used in developing this list, please visit the CDC Web site at www.cdc.gov.
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